News & opinion

1 AUG 2017

New for old

Let’s face it: none of us are getting any younger. But more of us are living longer.

Declining fertility rates and increasing longevity among populations of both developed and developing nations will lead to the number of people aged 65 and over growing from 530.5 million in 2010 to 1.5 billion in 2050. So, you would expect there to be a later-life housing building boom under way. In fact, there isn’t. Instead, a lack of accommodation for older people is set to be the next great housing crisis. If we are to avoid it, we need a retirement home revolution.

“We are facing a global imbalance as the numbers of people of working age shrink, while the numbers of those that have traditionally been their dependents grows,” warns David Sinclair, director of the UK branch of the International Longevity Centre (ILC) Global Alliance. The shift to a “greyer” population will be strongest in Asia and eastern and southern Europe. The Organisation for Economic Co-operation and Development (OECD) predicts that, in these regions, the number of people aged 65 and over for every 100 of those of a working age (15-64) is set to more than double. In China, it is due to quadruple.

The shift to a “greyer” population will be strongest in Asia and eastern and southern Europe.

As this demographic grows, where and how they live is becoming less suitable. Monica Ferreira, former co-president of the ILC Global Alliance, says: “In the developed world, affluent people tend to live on their own.” This creates a generation without sufficient help from younger family members that are prone to loneliness.

Some of the world’s most populous countries are among those in greatest need. In China, for example, where the speed and scale of the population’s ageing makes the need for later-life accommodation and care particularly acute, solutions are in their infancy. American Jim Biggs is managing director of Honghui Senior Housing Management Consulting Co, which has launched what it hopes will be the first of a chain of private care homes in Tianjin, China. He says: “In China, families were the traditional caregivers for the elderly. But the one-child policy has led to fewer working-age people to pay for the needs of their parents. Other families might have more money but they’ve moved away from the grandparents in the village to work in cities. There are some state-run care homes, but the range of choice that is needed, such as assisted living and retirement communities, are really only just starting to be developed.”

In India, the provision of options is similarly nascent. A 2013 ILC Alliance report, Housing for Older People Globally: What are the Best Practices?, reads: “India’s population aged 60+ is set to reach 315 million by 2050. There is an abysmal lack, however, of political and societal will to address the challenges this trend will bring.”

Ferreira believes that governments should give more focus to ageing: “In developing countries, policy for older people is usually non-existent because governments are reluctant to commit to things that might be difficult to deliver. There are policies but they don’t always translate into great places to live. For example, a common tendency is to focus on safety – ensuring that there are fire alarms – rather than comfort.”

Retirement developments also face financial challenges, not least the struggle to attract residents. Ben Hartley MRICS is director of UK-based Carterwood, a surveying firm that specialises in social care. He says: “This is a tough market to sell to, because people are more risk-averse now than the general population. For some people, the idea of moving out of a family home where they have lived for decades is traumatic. This means that they can take a long time to decide to move. So a developer could take, say, two years to sell a scheme.” This long wait, in turn, deters investors.

The lack of provision for an ageing population has a knock-on impact on the rest of society. Although older people are not necessarily better off in specially designed retirement housing, the dearth of this type of accommodation blocks many from moving out of larger family homes. This then prevents young families from moving into the space that they need. In the UK, for example, a 2013 report by thinktank Demos, called Top of the Ladder, found that a third of people over 60 want to move to a smaller home. Demos found that if only half of those keen to downsize did so, some 3.5 million homes would be made available.

John Slaughter, director of external affairs at the UK’s Home Builders Federation, adds: “Downsizing can take pressure off hospitals, as retirement housing has been proven repeatedly to improve the health and wellbeing of residents – many of whom are widows and widowers – by reducing loneliness.”

To establish a way forward, we must understand what type of environments older people need and will enjoy living in. Later-life housing experts agree that while building more – and better – retirement homes is part of the answer, there are other models that should be in the mix. Several inspiring initiatives around the world demonstrate some of the best approaches.

Taking retirement homes first, the US has pioneered the idea of the private “continuing care retirement community” (CCRC). The model allows residents to move into villages of sometimes thousands of people from the age of 55 and stay for the rest of their lives. As and when they need, they can move from fully independent living, to receiving varying degrees of care in their own home, to moving to an on-site care home, either for the short or long term. The US has honed this model so that the communities feel more like resorts, replete with swimming pools and golf courses. The CCRC can also help reduce the trauma that older people experience when they are forced to move between several locations in the later years of life as their health deteriorates.

The model is gaining ground in developed countries. Some of the best examples can be found in Japan, where, according to the national Statistics Bureau, in late 2015, one in four people were aged 65 or over. David Collins, chief executive of senior housing consultant Active Living International, says: “Japan is dealing with older people really well. They have adopted the CCRC model widely, they build beautiful environments and they think about how to make them work – for example, building them close to the rail network, which allows family to visit easily.”

Professor Duncan Maclennan HonRICS, director of the Centre for Housing Research at the University of St Andrews, says: “Most people in the world can’t afford retirement communities, so we need to think about more economical alternatives.”

An intergenerational model being trialled in France offers an interesting alternative. Older people cohabit with a younger person, who benefits from lower rent in return for being contracted to provide a level of support.

An intergenerational model being trialled in France offers an interesting alternative. Older people cohabit with a younger person, who benefits from lower rent in return for being contracted to provide a level of support, whether that is cooking, cleaning, or even simply spending time with them. Ferreira says: “This is a low-cost approach that avoids older people living apart from the rest of the community, while ensuring they have security and help if they need it.”

Some seniors, however, need a specialist environment – particularly those with dementia, a condition that non-profit organisation Alzheimer’s Disease International says affects one in five of those over 80. Gradmann Haus in Stuttgart, Germany, is a great example of how to tailor accommodation for specific needs. It caters for medium to advanced dementia sufferers and accommodates the impulses that they tend to have. For example, protected green space responds to the urge to wander and explore, while remaining in a safe environment. A cosy area, meanwhile, meets the needs of those seeking closeness to others.

For many, the best option is to stay in their own home. Stephen Oxley FRICS, director at Currie & Brown, says: “The point is the care that is received, and that people have dignity, choice and independence. And evidence suggests that people do best when they stay in a familiar environment and community.” The answer is, therefore, often for older people to stay in their own home, but adapt it – adding non-slip flooring and grab bars, for example – and provide care at home.

In Brazil, a series of initiatives sponsored by financial institutions show how what experts call “ageing in place” can be achieved in lower-income neighbourhoods, with apparently no cost to the taxpayer. The ILC cites a scheme in Rio de Janeiro and São Paulo, whereby porters in apartment buildings have been educated about issues that affect older residents, such as falls and building accessibility, and “empowered to engage with building owners” to persuade them to make improvements. At another bank-sponsored pilot project in a favela in Rio, community members are trained and paid to provide care for vulnerable older people.

The creation of the Brazilian schemes was prompted by the World Health Organization’s (WHO) “Age-friendly World” initiative to raise awareness of the need for cities to provide spaces that support older people. Ken Bluestone, influencing and policy lead at Age International, believes the initiative is a good starting point: “The WHO is providing good guidance for city planners and communities on how to respond to ageing populations. The idea is to think about issues such as how much time are traffic lights giving people to cross roads, and do we have enough benches in public areas.” Although by 2015, an encouraging 258 cities and neighbourhoods had committed to becoming “age friendly”, they represent just 28 countries, so there is still a way to go.

RICS professionals are well placed to raise greater awareness of the urgent need to respond to the rapid ageing of the population. Oxley says: “Firms like ours work across housing, health and care sectors, so there is a real opportunity for surveyors to bring the relevant sides together to develop solutions.”

Surveyors can then influence changes in built environments to better meet the needs of older people, and champion the best solutions from around the world.